0fe7650adba9a6ec76deac89f853a9c2 298697.pdf ee8fd4fe7402afff9f2b19b8e3e777ce080d3297 298697.pdf 4b66ace8a9522aaf9ddce3d9b0ee548872bd3d338f8fc42329731256be3f3586 298697.pdf Title: Performance of Primary Care Physicians in the Management of Glycemia, Lipids, and Blood Pressure among People with Type 2 Diabetes: A Cross-Sectional Study Subject: Background: Our study aimed to evaluate the performance of primary healthcare physicians (PCPs) in managing glycemia, lipids, and blood pressure in people with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. Methods: We included 3267 PCPs with 367,132 T2DM subjects in a cross-sectional analysis of the SIDIAP (Sistema d’Informació per al Desenvolupament de la Investigació en Atenció Primària) database for the year 2017. Results: 63.1% of PCPs were female, with an average practice size of 1512 subjects. T2DM individuals had a mean (standard deviation) age of 70 (12.2) years old, a mean body mass index (BMI) of 30.2 (5.21) kg/m2, and a median diabetes duration of 8.8 years. Overall, 42.6% of subjects achieved target glycemic control (glycated hemoglobin < 7%). Notably, 59.2% maintained blood pressure < 140/90 mmHg during the 12-month study period. The multivariable analysis identified positive associations between glycemic control and female PCPs, practice sizes (1000–1500 people), a higher proportion of patients aged 65 years, and rural practices. Combined glycemic, lipid, and blood pressure target attainment was associated with medium-sized practices and those with a higher proportion of patients aged 65 years. Conclusions: Practice size, patient age distribution, and rurality are factors associated with the performance of PCPs in the control of glycemia, lipids, and blood pressure in T2DM subjects in primary health care centers in our region. Keywords: T2DM; inter-professional variability; primary health care professionals; glycemic control; lipids; blood pressure Author: Bogdan Vlacho, Berta Fernandez-Camins, Albert Canudas-Ventura, Andrés Rodríguez, Àngels Mollo, Francesc Xavier Cos Claramunt, Maria Antentas, Dídac Mauricio and Josep Franch-Nadal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Mar 8 02:26:40 2024 CET ModDate: Fri Mar 8 02:29:15 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 298773 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MOVDQB+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 QTOFRP+VnURWPalladioL Type 1 Custom yes yes yes 16 0 BPMJIA+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 YRZYEB+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 VYWHVW+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 GQWIGS+CMSY10 Type 1 Builtin yes yes yes 37 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 56 0 RIJDHR+CMBSY10 Type 1 Builtin yes yes yes 91 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-12-05 02:52:45 CET RepresentationInformation: 298697.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-02 15:22:34 CET Size: 298773 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 301 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Settings Destination: subsection.2.1 Item: Title: Study Subjects Destination: subsection.2.2 Item: Title: Variables and Definitions Destination: subsection.2.3 Item: Title: Statistical Methods Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of PCPs and Subjects with T2DM Destination: subsection.3.1 Item: Title: Glycemia, Lipids, and Blood Pressure Control in Subjects with T2DM Destination: subsection.3.2 Item: Title: Variability among PCPs in the Control of Glycemia, Lipids, and Blood Pressure Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Performance of Primary Care Physicians in the Management of Glycemia, Lipids, and Blood Pressure among People with Type 2 Diabetes: A Cross-Sectional Study Author: Bogdan Vlacho, Berta Fernandez-Camins, Albert Canudas-Ventura, Andrés Rodríguez, Àngels Mollo, Francesc Xavier Cos Claramunt, Maria Antentas, Dídac Mauricio and Josep Franch-Nadal Subject: Background: Our study aimed to evaluate the performance of primary healthcare physicians (PCPs) in managing glycemia, lipids, and blood pressure in people with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. Methods: We included 3267 PCPs with 367,132 T2DM subjects in a cross-sectional analysis of the SIDIAP (Sistema d’Informació per al Desenvolupament de la Investigació en Atenció Primària) database for the year 2017. Results: 63.1% of PCPs were female, with an average practice size of 1512 subjects. T2DM individuals had a mean (standard deviation) age of 70 (12.2) years old, a mean body mass index (BMI) of 30.2 (5.21) kg/m2, and a median diabetes duration of 8.8 years. Overall, 42.6% of subjects achieved target glycemic control (glycated hemoglobin < 7%). Notably, 59.2% maintained blood pressure < 140/90 mmHg during the 12-month study period. The multivariable analysis identified positive associations between glycemic control and female PCPs, practice sizes (1000 1500 people), a higher proportion of patients aged 65 years, and rural practices. Combined glycemic, lipid, and blood pressure target attainment was associated with medium-sized practices and those with a higher proportion of patients aged 65 years. Conclusions: Practice size, patient age distribution, and rurality are factors associated with the performance of PCPs in the control of glycemia, lipids, and blood pressure in T2DM subjects in primary health care centers in our region. Keywords: T2DM; inter-professional variability; primary health care professionals; glycemic control; lipids; blood pressure Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Mar 08 02:26:40 CET 2024 ModDate: Fri Mar 08 02:29:15 CET 2024 ID: 0x997a311b756a0184388bde8c760ab79f, 0x997a311b756a0184388bde8c760ab79f Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: QTOFRP+VnURWPalladioL FontSubset: true FirstChar: 128 LastChar: 226 FontDescriptor: FontName: QTOFRP+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: VYWHVW+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: VYWHVW+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: GQWIGS+CMSY10 FontSubset: true FirstChar: 0 LastChar: 21 FontDescriptor: FontName: GQWIGS+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true Font: BaseFont: BPMJIA+URWPalladioL-Bold FontSubset: true FirstChar: 2 LastChar: 134 FontDescriptor: FontName: BPMJIA+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MOVDQB+VnURWPalladioL-Bold FontSubset: true FirstChar: 128 LastChar: 189 FontDescriptor: FontName: MOVDQB+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: YRZYEB+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 248 FontDescriptor: FontName: YRZYEB+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: RIJDHR+CMBSY10 FontSubset: true FirstChar: 21 LastChar: 21 FontDescriptor: FontName: RIJDHR+CMBSY10 Flags: Symbolic FontBBox: -26, -940, 1332, 825 FontFile: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 82, 279, 152, 288 Annotation: Subtype: Link Rect: 34, 267, 102, 276 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 125, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 149, 87 Annotation: Subtype: Link Rect: 34, 756, 176, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 131, 642, 142, 655 Annotation: Subtype: Link Rect: 277, 642, 288, 655 Annotation: Subtype: Link Rect: 416, 642, 427, 655 Annotation: Subtype: Link Rect: 520, 642, 531, 655 Annotation: Subtype: Link Rect: 110, 629, 121, 643 Annotation: Subtype: Link Rect: 471, 629, 482, 643 Annotation: Subtype: Link Rect: 170, 616, 181, 630 Annotation: Subtype: Link Rect: 130, 17, 267, 28 Annotation: Subtype: Link Rect: 424, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 412, 87, 431 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 338, 678, 345, 687 ActionDest: 102 Annotation: Subtype: Link Rect: 345, 678, 352, 687 ActionDest: 102 Annotation: Subtype: Link Rect: 346, 652, 353, 662 ActionDest: 102 Annotation: Subtype: Link Rect: 520, 602, 527, 611 ActionDest: 106 Annotation: Subtype: Link Rect: 322, 552, 329, 561 ActionDest: 106 Annotation: Subtype: Link Rect: 329, 552, 336, 561 ActionDest: 106 Annotation: Subtype: Link Rect: 430, 527, 437, 536 ActionDest: 106 Annotation: Subtype: Link Rect: 212, 477, 219, 486 ActionDest: 106 Annotation: Subtype: Link Rect: 425, 464, 432, 473 ActionDest: 106 Annotation: Subtype: Link Rect: 433, 464, 445, 473 ActionDest: 106 Annotation: Subtype: Link Rect: 380, 427, 392, 436 ActionDest: 106 Annotation: Subtype: Link Rect: 357, 402, 369, 411 ActionDest: 106 Annotation: Subtype: Link Rect: 359, 389, 371, 398 ActionDest: 106 Annotation: Subtype: Link Rect: 371, 389, 383, 398 ActionDest: 106 Annotation: Subtype: Link Rect: 412, 351, 424, 360 ActionDest: 106 Annotation: Subtype: Link Rect: 425, 351, 437, 360 ActionDest: 106 Annotation: Subtype: Link Rect: 250, 326, 262, 335 ActionDest: 106 Annotation: Subtype: Link Rect: 263, 326, 275, 335 ActionDest: 106 Annotation: Subtype: Link Rect: 270, 301, 282, 310 ActionDest: 106 Annotation: Subtype: Link Rect: 347, 251, 359, 260 ActionDest: 106 Annotation: Subtype: Link Rect: 359, 251, 371, 260 ActionDest: 106 Annotation: Subtype: Link Rect: 406, 226, 418, 235 ActionDest: 106 Annotation: Subtype: Link Rect: 388, 150, 400, 159 ActionDest: 106 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 324, 617, 336, 626 ActionDest: 106 Annotation: Subtype: Link Rect: 336, 617, 348, 626 ActionDest: 106 Annotation: Subtype: Link Rect: 295, 491, 307, 500 ActionDest: 106 Annotation: Subtype: Link Rect: 356, 202, 368, 211 ActionDest: 109 Annotation: Subtype: Link Rect: 212, 139, 224, 148 ActionDest: 109 Annotation: Subtype: Link Rect: 227, 139, 239, 148 ActionDest: 109 Annotation: Subtype: Link Rect: 544, 76, 556, 85 ActionDest: 109 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 507, 693, 519, 702 ActionDest: 109 Annotation: Subtype: Link Rect: 510, 279, 522, 288 ActionDest: 109 Annotation: Subtype: Link Rect: 523, 279, 535, 288 ActionDest: 109 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 435, 718, 447, 727 ActionDest: 109 Annotation: Subtype: Link Rect: 448, 718, 460, 727 ActionDest: 109 Annotation: Subtype: Link Rect: 165, 665, 286, 677 Annotation: Subtype: Link Rect: 274, 653, 543, 665 Annotation: Subtype: Link Rect: 482, 276, 489, 288 ActionDest: 79 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 413, 316, 420, 326 ActionDest: 82 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 522, 569, 529, 581 ActionDest: 85 Annotation: Subtype: Link Rect: 190, 112, 197, 122 ActionDest: 88 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 359, 253, 366, 265 ActionDest: 88 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 202, 407, 214, 416 ActionDest: 106 Annotation: Subtype: Link Rect: 215, 407, 227, 416 ActionDest: 109 Annotation: Subtype: Link Rect: 230, 407, 242, 416 ActionDest: 109 Annotation: Subtype: Link Rect: 286, 332, 298, 341 ActionDest: 109 Annotation: Subtype: Link Rect: 373, 218, 385, 228 ActionDest: 109 Annotation: Subtype: Link Rect: 195, 181, 207, 190 ActionDest: 109 Annotation: Subtype: Link Rect: 210, 181, 222, 190 ActionDest: 109 Annotation: Subtype: Link Rect: 491, 181, 503, 190 ActionDest: 109 Annotation: Subtype: Link Rect: 503, 181, 515, 190 ActionDest: 109 Annotation: Subtype: Link Rect: 268, 168, 280, 177 ActionDest: 109 Annotation: Subtype: Link Rect: 501, 143, 513, 152 ActionDest: 109 Annotation: Subtype: Link Rect: 277, 93, 289, 102 ActionDest: 109 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 413, 706, 425, 715 ActionDest: 112 Annotation: Subtype: Link Rect: 303, 630, 315, 639 ActionDest: 112 Annotation: Subtype: Link Rect: 544, 580, 556, 589 ActionDest: 112 Annotation: Subtype: Link Rect: 340, 555, 352, 564 ActionDest: 112 Annotation: Subtype: Link Rect: 442, 467, 454, 476 ActionDest: 106 Annotation: Subtype: Link Rect: 203, 430, 215, 439 ActionDest: 112 Annotation: Subtype: Link Rect: 360, 379, 372, 388 ActionDest: 112 Annotation: Subtype: Link Rect: 536, 329, 548, 338 ActionDest: 112 Annotation: Subtype: Link Rect: 494, 128, 506, 137 ActionDest: 109 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 526, 491, 560, 502 Annotation: Subtype: Link Rect: 165, 479, 359, 490 Annotation: Subtype: Link Rect: 354, 433, 365, 441 ActionDest: 112 Annotation: Subtype: Link Rect: 365, 433, 376, 441 ActionDest: 112 Annotation: Subtype: Link Rect: 397, 141, 434, 152 Annotation: Subtype: Link Rect: 442, 118, 479, 129 Annotation: Subtype: Link Rect: 346, 95, 383, 106 Annotation: Subtype: Link Rect: 390, 95, 426, 106 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 59, 719, 96, 729 Annotation: Subtype: Link Rect: 102, 719, 138, 729 Annotation: Subtype: Link Rect: 536, 706, 560, 718 Annotation: Subtype: Link Rect: 56, 695, 299, 706 Annotation: Subtype: Link Rect: 440, 637, 476, 648 Annotation: Subtype: Link Rect: 183, 569, 220, 579 Annotation: Subtype: Link Rect: 227, 569, 263, 579 Annotation: Subtype: Link Rect: 270, 534, 307, 545 Annotation: Subtype: Link Rect: 314, 534, 350, 545 Annotation: Subtype: Link Rect: 242, 500, 280, 510 Annotation: Subtype: Link Rect: 59, 477, 96, 487 Annotation: Subtype: Link Rect: 170, 453, 284, 464 Annotation: Subtype: Link Rect: 404, 453, 441, 464 Annotation: Subtype: Link Rect: 108, 420, 146, 430 Annotation: Subtype: Link Rect: 405, 361, 442, 372 Annotation: Subtype: Link Rect: 291, 339, 329, 349 Annotation: Subtype: Link Rect: 308, 304, 345, 315 Annotation: Subtype: Link Rect: 351, 304, 388, 315 Annotation: Subtype: Link Rect: 420, 281, 458, 292 Annotation: Subtype: Link Rect: 464, 281, 500, 292 Annotation: Subtype: Link Rect: 311, 259, 349, 269 Annotation: Subtype: Link Rect: 355, 259, 391, 269 Annotation: Subtype: Link Rect: 104, 224, 141, 234 Annotation: Subtype: Link Rect: 147, 224, 183, 234 Annotation: Subtype: Link Rect: 478, 200, 515, 211 Annotation: Subtype: Link Rect: 521, 200, 557, 211 Annotation: Subtype: Link Rect: 265, 177, 302, 188 Annotation: Subtype: Link Rect: 308, 143, 346, 154 Annotation: Subtype: Link Rect: 443, 120, 481, 131 Annotation: Subtype: Link Rect: 394, 108, 560, 119 Annotation: Subtype: Link Rect: 56, 97, 384, 108 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 95, 719, 131, 729 Annotation: Subtype: Link Rect: 56, 695, 241, 706 Annotation: Subtype: Link Rect: 393, 672, 430, 683 Annotation: Subtype: Link Rect: 181, 649, 560, 660 Annotation: Subtype: Link Rect: 56, 638, 114, 648 Annotation: Subtype: Link Rect: 105, 614, 560, 625 Annotation: Subtype: Link Rect: 56, 603, 152, 614 Annotation: Subtype: Link Rect: 410, 591, 560, 602 Annotation: Subtype: Link Rect: 56, 580, 521, 591 Annotation: Subtype: Link Rect: 536, 557, 560, 568 Annotation: Subtype: Link Rect: 56, 545, 385, 556 Annotation: Subtype: Link Rect: 118, 523, 155, 533 Annotation: Subtype: Link Rect: 458, 499, 496, 510 Annotation: Subtype: Link Rect: 502, 499, 538, 510 Annotation: Subtype: Link Rect: 443, 476, 480, 487 Annotation: Subtype: Link Rect: 418, 454, 455, 464 Annotation: Subtype: Link Rect: 293, 431, 331, 441 Annotation: Subtype: Link Rect: 337, 431, 373, 441 Annotation: Subtype: Link Rect: 144, 408, 182, 418 Annotation: Subtype: Link Rect: 275, 384, 313, 395 Annotation: Subtype: Link Rect: 216, 361, 253, 372 Annotation: Subtype: Link Rect: 469, 338, 507, 349 Annotation: Subtype: Link Rect: 59, 305, 96, 315 Annotation: Subtype: Link Rect: 102, 305, 138, 315 Annotation: Subtype: Link Rect: 446, 281, 483, 292 Annotation: Subtype: Link Rect: 490, 281, 526, 292 Annotation: Subtype: Link Rect: 271, 259, 307, 269 Annotation: Subtype: Link Rect: 427, 235, 464, 246 Annotation: Subtype: Link Rect: 470, 235, 506, 246 Annotation: Subtype: Link Rect: 59, 201, 96, 211 Annotation: Subtype: Link Rect: 102, 201, 138, 211 Annotation: Subtype: Link Rect: 428, 177, 466, 188 Annotation: Subtype: Link Rect: 131, 155, 168, 165 Annotation: Subtype: Link Rect: 283, 131, 321, 142 Annotation: Subtype: Link Rect: 249, 109, 286, 119 Annotation: Subtype: Link Rect: 104, 74, 141, 85 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 352, 730, 389, 741 Annotation: Subtype: Link Rect: 144, 696, 182, 706 Annotation: Subtype: Link Rect: 188, 696, 224, 706 Annotation: Subtype: Link Rect: 59, 650, 96, 660 Annotation: Subtype: Link Rect: 102, 650, 138, 660 Annotation: Subtype: Link Rect: 59, 615, 96, 625 Annotation: Subtype: Link Rect: 102, 615, 138, 625 Annotation: Subtype: Link Rect: 520, 591, 557, 602 Annotation: Subtype: Link Rect: 175, 569, 211, 579 Annotation: Subtype: Link Rect: 312, 545, 350, 556 Annotation: Subtype: Link Rect: 356, 545, 392, 556 Annotation: Subtype: Link Rect: 304, 522, 342, 533 Annotation: Subtype: Link Rect: 348, 522, 384, 533 Checksum: 9c38834c Type: CRC32 Checksum: 0fe7650adba9a6ec76deac89f853a9c2 Type: MD5 Checksum: ee8fd4fe7402afff9f2b19b8e3e777ce080d3297 Type: SHA-1 Checksum: 4b66ace8a9522aaf9ddce3d9b0ee548872bd3d338f8fc42329731256be3f3586 Type: SHA-256